What We Need to Know About Vaping & E-Cigarettes

Vaping was named as Oxford Dictionary’s word of the year for 2014. This year, you were 30 times more likely to hear the term used than in 2012[1]. The increased usage of the word correlates to increased use of nicotine-delivering devices that utilize vaporization, namely e-cigarettes. According to a study released by the Center for Disease Control and Prevention (CDC) in August 2014, the number of students in grades 6-12 who had never smoked a tobacco cigarette but had used an electronic cigarette tripled from 2011 to 2013[2]. Since the rates of vaping are on the rise, it is important that parents, educational professionals, and the surrounding community are aware of the terminology, side effects, and risks of future cigarette use.

Common terminology used when talking about vaping includes:

E-cigarette (e-cigs) – devices, usually shaped liked cigarettes but sometimes shaped like other common objects such as flash drives or pens that are used to deliver nicotine.

Vape – this can refer to the action of inhaling the vapor produced by heating liquid (usually nicotine and flavoring) inside of the e-cigarette device. This is also commonly used to refer to the device itself.

E-hookah/Hookah pens – similar to e-cigarettes, these devices are used to smoke hookah which can either contain nicotine, or can be nicotine-free. [4]

Regardless of the method used, a user is vaping when he or she uses a device that heats a liquid and creates a vapor, which the user inhales. The byproduct of vaping is water-based and therefore does not leave the residue and smell associated with the use of smoking tobacco.

It is important to recognize that vaping does carry potential risks to your health. Since long-term research has not been done on vaping, until recently, it has been thought of and advertised as a “safe alternative” to smoking traditional cigarettes. Current studies are indicating that this may not be the case. According to the National Institute on Drug Abuse (NIDA), carcinogens, chemicals including formaldehyde and acetaldehyde, and metal nanoparticles have been found in the vapor from e-cigarettes[5]. The Food and Drug Administration (FDA) also has concerns about these devices. The FDA only regulates e-cigarettes that are marketed for therapeutic use, so some e-cigarettes are not FDA approved, and therefore can have dangerous inconsistencies in labeling and ingredients. Recent studies by the FDA have found that some cartridges labeled nicotine-free actually contained nicotine, which is an addictive substance. In another example, 3 e-cigarettes that were labeled to contain the same amounts of nicotine actually delivered 3 different amounts of nicotine.[6]

There are two specific added risks when using e-cigarettes with refillable cartridges: cartridges can be filled with liquid other than nicotine, which can be a way to deliver other drugs such as marijuana[7] or users can be poisoned with nicotine while refilling cartridges. While official information on using e-cigarettes to deliver marijuana is limited, a quick search for “vaping marijuana” produces numerous articles and videos teaching how to adapt the e-cigarettes for this purpose. The form of marijuana that is used in one of these devices is not the plant form, but instead is an extract referred to as “wax” or “honey oil” which is very dangerous to produce as it uses butane which is flammable and potentially explosive[8]. The second concern is possible nicotine poisoning from the liquid used in these cartridges. The rates of poisoning from e-cigarette liquids are on the rise as well. The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from 1 per month in September 2010 to 215 per month in February 2014. The risk of nicotine poisoning comes from the liquid being absorbed through the skin, inhalation, or ingestion. Additionally, the liquids that are sold sometimes come in fruit or candy flavors, which can lead to children mistaking them for something edible. Risks from nicotine poisoning include vomiting, nausea, and eye irritation.[9]

Information recently released by the National Youth Tobacco Survey indicates an additional reason for concern about use of e-cigarettes: an increase in intention to smoke tobacco cigarettes in teens that have used the devices. One major finding of the survey was that of teens who had never used e-cigarettes, 21.5% intended to smoke traditional cigarettes in the future. However, of teens that had used e-cigarettes at least once, 43.9% intended to smoke traditional cigarettes in the future. This is a significant difference. The study also indicated that rates of teen e-cigarette use are on the rise. The number of teens who have never smoked traditional cigarettes, but had used e-cigarettes increased from 79,000 in 2011 to over 263,000 in 2013[10].

What does this information mean for people working with, raising, or influencing teenagers? First, we have to know about vaping, because use among teens is increasing. Second, recent research indicates that vaping carries potential health risks and seems to be a frequent gateway to tobacco use. Thus, discussing vaping and e-cigarettes with teens is just as urgent as discussing the use of tobacco, in order to help them make safe, healthy decisions.

[2] Centers for Disease Control and Prevention, Electronic Cigarettes Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/ on November 28, 2014

[3] National Institute on Drug Abuse. Electronic Cigarettes (e-Cigarettes) Retrieved from http://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes on December 8, 2014

[4] Centers for Disease Control and Prevention, Hookahs Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm on November 28, 2014

[5] National Institute on Drug Abuse. Electronic Cigarettes (e-Cigarettes) Retrieved from http://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes on November 28, 2014

[6] Food and Drug Administration. E-Cigarettes: Questions and Answers Retrieved from http://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm on November 28, 2014

[7] National Institute on Drug Abuse. Electronic Cigarettes (e-Cigarettes) Retrieved from http://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes on November 28, 2014

[8] Drug Enforcement Agency, The Dangers and Consequences of Marijuana Abuse Retrieved from http://www.dea.gov/docs/dangers-consequences-marijuana-abuse.pdf on November 28, 2014

[9] Centers for Disease Control and Prevention, New CDC study finds dramatic increase in e-cigarette-related calls to poison centers Retrieved from http://www.cdc.gov/media/releases/2014/p0403-e-cigarette-poison.html on November 28, 2014

[10] Centers for Disease Control and Prevention, Electronic Cigarettes Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/ on November 28, 2014